Individual provider Active NPI

Alyson Buck, PA-C

  • Medical Physician Assistant
  • North Haven, CT
National Provider Identifier
1053506295
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
001951 Issued in CT
Practice address
15 Country Way
North Haven, CT 06473-2415
Phone
(267) 312-3142
NPI assigned
Sep 11, 2007
Last updated
Aug 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001951 CT Primary

Addresses

Primary practice location

15 Country Way
North Haven, CT 06473-2415

Mailing address

15 Country Way
North Haven, CT 06473-2415

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080418000139 CT Practitioner - Physician Assistant 5890873657 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1951CTMDChiropractor
001951CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital CurrentSince Apr 6, 2015 Accepting new patients
Yale University CurrentSince Jan 1, 2014 Accepting new patients
Yale University CurrentSince Jan 1, 2014 Accepting new patients
Connecticut Children's Specialty Group, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Connecticut Pathology Group PC Current Accepting new patients
Middlesex Hospital CurrentSince Apr 6, 2015 Accepting new patients
Saint Raphael Healthcare System Affiliated Physicians Inc Past Accepting new patients
Saint Raphael Faculty Physicians Past Accepting new patients

Locations

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

90 S Main St
Middletown, CT 06457
Phone (860) 358-6300

1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

Interoperability endpoints

  • Direct secure messaging: abuck18569@middlesexhealthprd.direct-ci.com
  • Direct secure messaging: abuck64348@direct.ynhh.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1053506295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 COUNTRY WAY",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 COUNTRY WAY",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732415",
            "telephone_number": "267-312-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "ALYSON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "001951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Haven, CT

Sources for this page

Verify at the official NPI Registry.